Comparison of intranasal midazolam and sufentanil premedication in pediatric outpatients*

Zedie, Nishat; Amory, David W.; Wagner, Bertil K.J.; O′Hara, Dorene A.

doi:10.1016/s0009-9236(96)80012-9

Cited by 55 publications

(25 citation statements)

References 12 publications

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“…The median onset of sedation was significantly shorter in group M 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) min than in group D 25(20-40) min (P = 0.001) ( Table 2). Consequently, the time from premedication to induction was also significantly shorter in group M than in group D (P = 0.002) ( Table 1).…”

Section: Resultsmentioning

confidence: 97%

Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double‐blinded randomized controlled trial

Sheta

AlSarheed

Abdelhalim

2013

Pediatric Anesthesia

146

163

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Section: Resultsmentioning

confidence: 97%

Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double‐blinded randomized controlled trial

Sheta

AlSarheed

Abdelhalim

2013

Pediatric Anesthesia

146

163

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“…However, most studies have evaluated its use for premedication or sedation using the IN route, and not for postoperative analgesia. [7][8][9][10][11] Nasal administration of drugs must be done using small volumes to avoid irritation of nasal mucosal membranes. The maximum volume to avoid run-off into the pharynx by a single administration in one nostril in adults is 150 µL.…”

Section: Resultsmentioning

confidence: 99%

Intranasal sufentanil is effective for postoperative analgesia in adults

Mathieu¹,

Cnudde²,

Engelman³

et al. 2006

Can J Anesth/J Can Anesth

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Purposes:The aim of this prospective, randomized, doubleblind study was to compare two doses of intranasal sufentanil for postoperative analgesia, titrated according to individual requirements based upon a numeric rating scale (NRS) from 0 to 10 for pain.Methods: Forty patients, American Society of Anesthesiologists physical status I-II, scheduled for herniorrhaphy or hemorrhoidectomy under general anesthesia, were included when postoperative NRS was > 3. Nurses used a nasal puff device delivering a constant volume. Patients were randomized into two groups: Group A patients received a dose of 0.025 µg·kg -1 /puff, Group B patients a dose of 0.05 µg·kg -1 /puff. Puffs were administered as often as needed to obtain NRS ≤ 3, with an interval time of five minutes. Hemodynamic, respiratory measures and sedation were recorded every five minutes. Results:The probability of persistence of pain in Group B was consistently lower than in Group A. After 20 min, 20% of the patients had a NRS score > 3 in Group B, as opposed to 60% in Group A. At 60 min, no patient had a NRS > 3 in Group B, whereas there was a probability of 20% to record a NRS > 3 for Group A. Hemodynamic, respiratory parameters and sedation remained stable with no intergroup differences.Conclusions: Nasal administration of 0.050 µg·kg -1 /puff sufentanil allowed a NRS < 4 to be attained within one hour in all patients, with efficacy achieved after 20 min. These findings suggest that the intranasal route is an effective mode of sufentanil administration for immediate postoperative analgesia in adult patients. Objectif

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“…The group receiving 4.5 μg·kg −1 showed a marked decreased ventilatory compliance during the induction of anesthesia and had a higher incidence of vomiting during the first postoperative day. Zedie and coworkers (26) compared intranasal midazolam (0.2 mg·kg −1 ) with sufentanil (2 μg·kg −1 ) premedication in 60 pediatric outpatients. Children who received midazolam were more likely to cry upon administration, compared with sufentanil.…”

Section: Pharmacokineticsmentioning

confidence: 99%

Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice

Lundeberg

Roelofse

2010

Pediatric Anesthesia

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Sufentanil is a potent synthetic opioid. Like other opioids, sufentanil creates a stable hemodynamic environment in cardiovascularly compromised pediatric patients. Clearance, expressed as per kilogram, is increased in children compared to adults. The P450 CYP3A4 enzyme is responsible for the major metabolic N-dealkylation pathway. Enzyme activity is reduced in neonates but the maturation of sufentanil clearance is not described. The free active fraction is affected by age because of the reduced α(1) -acid glycoprotein plasma concentrations in neonates. Intranasal administration of sufentanil is a possible option for premedication, procedural sedation and analgesia in children, as this option has been found to be safe and effective. Studies concerning the pharmacokinetics and dynamics of sufentanil administered as a bolus or continuous infusion in children are few.

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Comparison of intranasal midazolam and sufentanil premedication in pediatric outpatients*

Cited by 55 publications

References 12 publications

Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double‐blinded randomized controlled trial

Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double‐blinded randomized controlled trial

Intranasal sufentanil is effective for postoperative analgesia in adults

Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice

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